Anemia chronic kidney disease
Conditions
Interventions
oral daprodustat
or rhEPO [intravenous (IV) epoetin alfa or subcutaneous (SC) darbepoetin alfa].
anemia
chronic kidney disease
dialysis subjects
erythropoietin
Sponsors
GlaxoSmithKline
Eligibility
Age
18 Years to 64 Years
Inclusion criteria
Inclusion criteria: A subject will be eligible for inclusion in this study only if all of the following criteria apply at screening (Week -8) and randomization (Day 1) unless otherwise specified. 1. Age (confirm at screening only): 18 to 99 years of age (inclusive). 2. ESAs: Use of any approved ESA for at least the 6 weeks prior to screening and between screening and randomization. 3. Hgb concentration measured by HemoCue (range is specified in protocol) 4. Dialysis: On dialysis > 90 days prior to screening and continuing on the same mode of dialysis from screening (Week -8) through to randomization (Day 1). 5. Frequency of Dialysis: * - HD: *2 times/week * - PD: * 5 times/week * - Home HD: (*2times/week) 6. Compliance with placebo [randomization (Day 1) only]: *80% and * 120% compliance with placebo during run-in period (NOTE: this is in addition to ESA treatment). 7. Informed consent (screening only): capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the consent form and in this protocol.
Exclusion criteria
Exclusion criteria: A subject will not be eligible for inclusion in this study if any of the following criteria apply at screening (Week -8) or randomization (Day 1), unless otherwise specified. CKD related criteria 1. Kidney transplant: Planned living-related or living-unrelated kidney transplant within 52 weeks after study start (Day 1). Anemia related criteria 2. Ferritin (screening only): *100 ng/mL (*100 ug/L). 3. Transferrin saturation (TSAT) (screening only): *20%. If TSAT is 18-20%, then a retest using a new blood sample can be obtained within 7 days of the final laboratory report; the final retest value must be >20% to confirm eligibility. 4. Aplasias: History of bone marrow aplasia of pure red cell aplasia. 5. Other causes of anemia: Untreated pernicious anemia, thalassemia major, sickle cell disease or myelodysplastic syndrome. 6. Gastrointestinal (GI) bleeding: Evidence of actively bleeding gastric, duodenal, or esophageal ulcer disease OR clinically significant GI bleeding *4 weeks prior to screening through to randomization (Day 1). CV disease-related criteria 7. MI or acute coronary syndrome: *4 weeks prior to screening through to randomization (Day 1). 8. Stroke or transient ischemic attack: *4 weeks prior to screening through to randomization (Day 1). 9. Heart failure (HF): Chronic Class IV HF, as defined by the New York Heart Association (NYHA) functional classification system. 10. Current uncontrolled hypertension: Current uncontrolled hypertension as determined by the investigator that would contraindicate the use of rhEPO. 11. QTcB (Day 1): QTcB >500 msec, or QTcB >530 msec in subjects with bundle branch block. There is no QTc exclusion for subjects with a predominantly ventricular paced rhythm. Other disease-related criteria 12. Liver disease: (any one of the following): - Alanine transaminase (ALT) >2x upper limit of normal (ULN) (screening only) - Bilirubin >1.5xULN (screening only) NOTE: Isolated bilirubin >1.5xULN is acceptable if bilirubin is fractionated and direct bilirubin 3cm. Note: The only exception is localized squamous cell or basal cell carcinoma of the skin that has been definitively treated 4 weeks prior to screening. Concomitant medication and other randomized treatment-related criteria 14. Severe allergic reactions: History of severe allergic or anaphylactic reactions or hypersensitivity to excipients in the investigational product (refer to daprodustat IB), or epoetin alfa or darbepoetin alfa (refer to product labeling). 15. Drugs and supplements Use of strong inhibitors of CYP2C8 (e.g., gemfibrozil) or strong inducers of CYP2C8 (e.g., rifampin/rifampicin). 16. Other study participation: Use of other investi
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| - Time to first occurrence of adjudicated major adverse cardiovascular event (MACE) [composite of all-cause mortality, non-fatal myocardial infarction (MI) and non-fatal stroke] - Mean change in Hgb between baseline and evaluation period (EP, mean over Weeks 28 to 52) | — |
Secondary
| Measure | Time frame |
|---|---|
| Time to first occurrence of adjudicated -MACE -MACE or a thromboembolic event (vascular access thrombosis, deep vein thrombosis or pulmonary embolism) -MACE or a hospitalization for heart failure (HF) Average monthly IV iron dose (mg)/subject to Week 52 Safety: -Incidence and severity of AEs and serious adverse events (SAEs) including AEs of special interest -Reasons for discontinuation of study treatment -Absolute values and changes from baseline in laboratory parameters, BP and heart rate (HR) | — |
Countries
Argentina, Australia, Austria, Belgium, Brazil, Bulgaria, Canada, Czechia, Denmark, Estonia, France, Germany, Greece, Hungary, India, Israel, Italy, Korea (the Democratic Peoples Republic of), Malaysia, Mexico, Netherlands, New Zealand, Norway, Philippines, Poland, Portugal, Romania, Russian Federation, Singapore, South Africa, Spain, Sweden, Taiwan (Province of China), Thailand, Turkey, Ukraine, United Kingdom, United States of America
Outcome results
None listed